Past Issues

The debate on health care is heating up. Last year, Blue Cross and Blue Shield of Florida (BCBSF) asked consumers to voice their ideas about how to improve health care. Our website, www.thepowerofthehumanvoice.com, was flooded with comments. Were yours among them?

Providers who participate in our Medicare Advantage networks should have recently received contract amendments containing updated CMS language requirements for the provider agreement.

Blue Cross and Blue Shield of Florida (BCBSF) and Florida Combined Life (FCL) have launched the Total Health Program, a joint effort promoting the benefits of good oral health to members enrolled in both our health and dental plans, with a particular focus on members with diabetes and coronary artery disease, as well as pregnant women.

A Physician's Concerns, Feedback and Recommendations Form has been added to the Blue Cross and Blue Shield of Florida (BCBSF) website.

Availity¹ has made its easy-to-use electronic prescribing solution better than ever by offering a new capability to further improve patient safety.

Physicians and providers can now reduce the time it takes to access a Blue Cross and Blue Shield of Florida member’s Availity¹ CareProfile^® by using the new batch capability.

Blue Cross and Blue Shield of Florida (BCBSF) saw a substantial enrollment increase in its newly introduced low-cost products during 2008, as Floridians searched for affordable health insurance options for themselves and their families during a slowing economy.

In April 2009, Blue Cross and Blue Shield of Florida (BCBSF) is introducing a new generic pharmacy benefit for members of some group health plans effective with their renewal dates.

Availity¹ now offers a new option for the transmission of real-time Florida Medicaid eligibility and benefits and claim status inquiries.

When requesting an electronic or phone prior authorization for member services, providers must submit the name of the practitioner who will be rendering the authorized services.

With the liquidation of Circuit City’s U.S. operations, health insurance coverage for Circuit City employees through Blue Cross terminated as of March 31, 2009.

During March, Blue Cross and Blue Shield of Florida (BCBSF) enhanced the 835 electronic remittance advice (ERA) for federal employees enrolled in the Blue Cross Blue Shield Service Benefit Plan.

These days everyone is looking for ways to be environmentally friendly and improve their bottom line. “Go green and help your business,” says Darnell Smith, group vice president of Blue Cross and Blue Shield of Florida’s (BCBSF) Service Organization. “Sign up today for electronic funds transfer and remittance advices!”

CareCalc^® Real-Time Claim Adjudication (RTCA), the first tool in the health care industry to combine patient financial responsibility with real-time claim adjudication, has been enhanced with a new section that enables users to enter rendering provider information when it differs from the billing provider.

The Centers for Medicare & Medicaid Services (CMS) has determined that there is insufficient evidence that virtual colonoscopy, or CT colonography, as a screening tool for colorectal cancer improves outcomes in asymptomatic, average-risk Medicare beneficiaries when compared with conventional colonoscopy.

The Florida SHOTS^TM program and registry is one way physicians can help advance the health of Florida’s youngest citizens—the children in our state.

Effective April 1, 2009, Blue Cross and Blue Shield of Florida (BCBSF) and Health Options implemented a prior authorization requirement for coverage on the antifungal products Vfend^® and Noxafil^®, as well as injectable growth hormones. The change is designed to ensure usage that meets drug manufacturers’ and Food and Drug Administration (FDA) approved label indications.

Effective April 1, 2009, Blue Cross and Blue Shield of Florida (BCBSF) and Health Options expanded the Responsible Step and Responsible Quantity components of the Responsible Rx program for BlueCare, BlueChoice, BlueOptions and BlueSelect members. Responsible Rx refers to an umbrella of pharmacy programs that also includes the Responsible Dose program.

Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, began conducting its 2009 Healthcare Effectiveness Data and Information Set (HEDIS^®) study in provider offices in March.

The addition of BlueMedicare PPO into the National Imaging Associates, Inc. (NIA) pre-authorization process for advanced imaging services was delayed.

Effective April 1, 2009, Blue Cross and Blue Shield of Florida (BCBSF) and its HMO subsidiary, Health Options, will include coverage for services related to autistic spectrum disorders for certain contracts issued or renewed on or after that date.

The article “New link added to online provider directory” published in BlueLine’s January/February issue erroneously reported that a link was added to our online provider directory identifying gay-friendly physicians.

Have you recently joined our provider network(s), added a new line of business, added a physician to your practice or hired new staff?

Last year, enhancements were added to MyBlueService^SM, Blue Cross and Blue Shield of Florida’s (BCBSF) online tool for members.

Mark your calendars! We look forward to seeing you at our new Provider Connection Seminars.

Employees of Polk County Schools have access to a school board sponsored Employee Assistance Program (EAP).

Beginning in August 2009, Blue Cross and Blue Shield of Florida’s Quality Improvement (QI) Program will include the Diagnostic Imaging Quality Assessment Program as an area of focus.

Has your office moved? Have you added a new location? Are your network and hospital affiliations correctly identified on our website? Please take a few minutes to verify information we have for your office by June 1.